Severe ifosfamide-induced neurotoxicity: a case report

Pharm World Sci. 2010 Apr;32(2):109-11. doi: 10.1007/s11096-009-9354-4. Epub 2009 Dec 23.

Abstract

Introduction: Ifosfamide is an alkylating agent used in the treatment of several neoplasias. Ifosfamide metabolites accumulation can produce neurotoxicity, which sometimes manifests as a severe clinical picture.

Case description: We describe the case of a male with a mixed cellularity subtype classical Hodgkin's lymphoma, treated with ifosfamide after other chemotherapy drugs failure. After the first Ifosfamide cycle, the patient showed severe neurological toxicity that resolved 3 weeks later with supportive therapy.

Discussion: Among the risk factors described in the literature, our patient had previously received cisplatin chemotherapy, had low albumin serum levels, and had received ifosfamide as a rapid intravenous infusion. The management of the neurotoxicity is symptomatic although some drugs, like methylene blue and albumin, have also been used.

Conclusion: This case highlights that clinicians should be aware of the possibility of severe neurological toxicity after the administration of ifosfamide and may control the risk factors associated.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents, Alkylating / adverse effects*
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Hodgkin Disease / drug therapy
  • Humans
  • Ifosfamide / adverse effects*
  • Ifosfamide / therapeutic use
  • Male
  • Neurotoxicity Syndromes / etiology*

Substances

  • Antineoplastic Agents, Alkylating
  • Ifosfamide